Health insurance reform, including more timely access for patients, will roll out early next year, said Medicaid Services Administrator Dr. Mehmet Oz.

Oz announced these reforms, along with Secretary of Health and Human Services Robert F. Kennedy Jr., at a news conference in Washington, D.C. on Monday.

The changes, which are voluntary, focus on prior authorization, which means insurers require approval before covering medical care, a prescription or services like an imaging exam. Insurers say they do this to guard against care overuse and to make sure patients get the right treatment.

“It frustrates doctors, it sometimes that results in care that is significantly delayed, it erodes public trust in the healthcare system” said Oz at a news conference in Washington, D.C.

Grey’s Anatomy actor Eric Dane said prior authorization impacts chronic illnesses, such as ALS.

“The worst thing that we can do is add even more uncertainty for patients and their loved ones with unnecessary prior authorization,” Dane said.

Sen. Roger Marshall, R-Kans., said he is also working on legislation about prior authorization.

“I think we owe it to our patients to go ahead and codify something,” Marshall said.

On Monday, UnitedHealthcare, CVS Health’s Aetna and dozens of other insurers announced they plan to reduce the scope of health care claims subject to prior authorization, standardize parts of the process and expand responses done in real time.

“I want to applaud the insurance companies for taking that very brave first step,” Oz said.

Insurers also announced that they will standardize electronic prior authorization by the end of next year, as well as reduce the scope of claims subject to medical prior authorization. They also plan to expand the number of real-time responses and ensure medical reviews are done for denied requests.

They will also honor the preapprovals of a previous insurer for a window of time after someone switches plans.

Oz called the practice “a pox on the system” that hikes administrative costs during his Senate confirmation hearing in March.

_____________

The Associated Press contributed to this report.

Members of the autism community are pushing back against Health and Human Services Secretary Robert F. Kennedy Jr.’s pledge to find the cause for autism by September, calling the plan harmful.

Kennedy announced last week that the Department of Health and Human Services (HHS) will launch a “massive testing and research effort” to find the cause of autism spectrum disorder in the next five months. He then followed up earlier this week by stating in a press conference that the agency would have “some answers” by then.

During the Wednesday press conference, Kennedy stressed that HHS would investigate an “environmental toxin” he believes is causing rising rates of autism spectrum disorder, contradicting what the Centers for Disease Control and Prevention (CDC) believes is contributing to the increased prevalence of the condition.

The Autism Society of America’s Chief Marketing Officer Kristyn Roth described Kennedy’s focus on an environmental toxin as “incredibly misleading” and his commitment to finding a definitive cause of autism spectrum disorder as harmful to the autism community.

“While more research is needed, there has been no discussion about actually serving this community to be better supported, included and to have services that reflect the diversity across the spectrum,” Roth told The Hill.

The CDC published a report earlier this week that found 1 in 31 children in the United States were diagnosed with autism spectrum disorder in 2022, continuing a trend of rising prevalence from previous years. The report noted that the increasing rate was likely linked to improved diagnostic methods that have become more widely available.

But Kennedy expressed skepticism that improved diagnostics are the reason for the rise, telling reporters that it has to be environmental and there is no genetic link to the condition.

“One of the things I think we need to move away from today is this ideology that the autism prevalence increases, the relentless increases, are simply artifacts of better diagnoses, better recognition, or changing diagnostic criteria,” he said.

“This is a preventable disease. We know it’s an environmental exposure. It has to be. Genes do not cause epidemics. It can provide a vulnerability. You need an environmental toxin.”

Research suggests that autism spectrum disorder stems from a combination of genetic factors and environmental influences. Autism researcher and clinician Doreen Samelson said that over 100 genes have been identified as being associated with autism spectrum disorder.

“I think the term epidemic implies a single identified cause, but I don’t think autism works that way,” she said. “It’s a complex, life-long condition, and since we have moved to kind of a spectrum we are really viewing a very broad population with a lot of diversity within that population.”

Roth added that the Trump administration’s cuts to the Department of Education and HHS and proposed cuts to Medicaid are in “direct opposition” to Kennedy’s claim that he wants to support the autism community and find out more about the condition.

Amid the administration’s broader efforts to slash the size and scope of the federal government, it has carried out mass firings at HHS and the Education Department and signaled it intends to make much deeper cuts at both agencies. An initial draft of the White House budget request reportedly calls for reducing HHS’s budget by a third, while Trump has signed an executive order seeking to dismantle the Education Department entirely.

The recently passed House budget resolution, meanwhile, proposes cutting up to $800 billion or more from Medicaid over the next 10 years as way to help pay for tax cuts.

Instead of cutting government spending or proposing studies to find “environmental toxins” contributing to autism, she said, there should be more investments in rigorous, peer-reviewed science to find out more about the condition.

Kennedy’s language when speaking about HHS’s plan to find a cause for autism spectrum disorder is also “harmful,” Roth said, particularly his comments suggesting that those with the condition will never be productive members of society.

Kennedy falsely claimed during the press conference this week that most cases of autism spectrum disorder are now severe and that the condition “destroys families.”

“These are kids who will never pay taxes, they’ll never hold a job, they’ll never play baseball, they’ll never write a poem, they’ll never go on a date,” he told reporters. “Many of them will never use a toilet unassisted. And we need to recognize that we are doing this to our children.”

Roth called the comments “inaccurate” and said that Kennedy mischaracterized an entire community.

“So many people know and love someone [with autism] who can do all of those things.”

Since autism falls along a spectrum, there are many people with the condition who achieve complete independence, while others might need constant care. But even those people, Roth added, can lead “meaningful, quality lives.”

“To insinuate and define people’s experiences and inaccurately claim that autism destroys families is so harmful and destructive.”

The nation’s major health insurers are promising to scale back and improve a widely despised practice that leads to care delays and complications.

Watch in the player above.

UnitedHealthcare, CVS Health’s Aetna and dozens of other insurers say they plan to reduce the scope of health care claims subject to prior authorization, standardize parts of the process and expand responses done in real time.

Prior authorization means insurers require approval before they’ll cover medical care, a prescription or a service like an imaging exam. Insurers say they do this to guard against care overuse and to make sure patients get the right treatment.

WATCH: Why insurance companies are denying coverage for prosthetic limbs

But doctors say the practice has grown in scope and complication, leading to frequent care delays. The fatal shooting of UnitedHealthcare CEO Brian Thompson in December prompted many people to vent their frustrations with coverage issues like prior authorization.

Dr. Mehmet Oz called the practice “a pox on the system” that hikes administrative costs during his Senate confirmation hearing in March to lead the Centers for Medicare and Medicaid Services.

Insurers said Monday that they will standardize electronic prior authorization by the end of next year to help speed up the process. They will reduce the scope of claims subject to medical prior authorization, and they will honor the preapprovals of a previous insurer for a window of time after someone switches plans.

READ MORE: UnitedHealthcare CEO shooting opens floodgates of Americans venting insurance frustrations

They also plan to expand the number of real-time responses and ensure medical reviews are done for denied requests.

Researchers say prior authorization has grown more common as care costs have climbed, especially for prescription drugs, lab testing, physical therapy and imaging exams.

“We’re sort of trapped between care being unaffordable and then these nonfinancial barriers and administrative burdens growing worse,” said Michael Anne Kyle, an assistant professor at the University of Pennsylvania who studies how patients access care.

Nearly all customers of Medicare Advantage plans, the privately run version of the federal government’s Medicare program, need prior authorization for some services, particularly expensive care like hospital stays, the health policy research organization KFF found in a study of 2023 claims. The study also found that insurers denied about 6% of all requests.

Dr. Ashley Sumrall of Charlotte, North Carolina, says she has seen an increase in prior authorizations required for routine exams like MRIs. An oncologist who treats brain tumors, Sumrall said these images are critical for doctors to determine whether a treatment is working and to plan next steps.

READ MORE: 1 in 5 Americans are on Medicaid. Some enrollees have no idea

Doctors say delays from requests that are eventually approved or coverage rejections can harm patients by giving a disease time to progress untreated. They also can spike anxiety in patients who want to know whether their tumor has stopped growing and if insurance will cover the scan.

“There’s a term that we use called ‘scanxiety,’ and it’s very real,” said Sumrall, a member of the Association for Clinical Oncology’s volunteer leadership.

Different forms and varied prior authorization policies also complicate the process. Sumrall noted that every insurer “has their own way of doing business.”

“For years, the companies have been unwilling to compromise, so I think any step in the direction of standardization is encouraging,” she said.

The insurers say their promises will apply to coverage through work or the individual market as well as Medicare Advantage plans and the state and federally funded Medicaid program.

The Trump administration is remaking the healthcare policy landscape with major implications for providers, payers and health IT firms.

Those changes include drastic overhauls to the Department of Health and Human Services, the agency now under the purview of Secretary Robert F. Kennedy Jr., and responsible for dictating payment rates for doctors and providing health coverage to tens of millions of Americans. Approximately 1 in 4 employees in the HHS have been laid off, pushed to retire early or encouraged to take a buyout.

More downsizing may be forthcoming. A leaked budget document shows the Trump administration aims to slash HHS spending by one-third.

More changes are coming from the new CMS Administrator Dr. Mehmet Oz. A former television personality, Oz has promised to scrutinize Medicare Advantage plans after Democrats raised concerns about his previous advocacy for the program. But so far, the Trump administration has proposed favorable policy for MA plans, including a dramatic rate increase.

Medicaid could see major revisions too. The safety-net insurance program could be the target of cuts after congressional Republicans proposed a federal budget that could reduce funding for the program.

Healthcare Dive is closely covering the changes in healthcare under the Trump administration. Keep tabs on the latest major developments using this tracker:

Health insurance reform, including more timely access for patients, will roll out early next year, said Medicaid Services Administrator Dr. Mehmet Oz.

Oz announced these reforms, along with Secretary of Health and Human Services Robert F. Kennedy Jr., at a news conference in Washington, D.C. on Monday.

The changes, which are voluntary, focus on prior authorization, which means insurers require approval before covering medical care, a prescription or services like an imaging exam. Insurers say they do this to guard against care overuse and to make sure patients get the right treatment.

“It frustrates doctors, it sometimes that results in care that is significantly delayed, it erodes public trust in the healthcare system” said Oz at a news conference in Washington, D.C.

Grey’s Anatomy actor Eric Dane said prior authorization impacts chronic illnesses, such as ALS.

“The worst thing that we can do is add even more uncertainty for patients and their loved ones with unnecessary prior authorization,” Dane said.

Sen. Roger Marshall, R-Kans., said he is also working on legislation about prior authorization.

“I think we owe it to our patients to go ahead and codify something,” Marshall said.

On Monday, UnitedHealthcare, CVS Health’s Aetna and dozens of other insurers announced they plan to reduce the scope of health care claims subject to prior authorization, standardize parts of the process and expand responses done in real time.

“I want to applaud the insurance companies for taking that very brave first step,” Oz said.

Insurers also announced that they will standardize electronic prior authorization by the end of next year, as well as reduce the scope of claims subject to medical prior authorization. They also plan to expand the number of real-time responses and ensure medical reviews are done for denied requests.

They will also honor the preapprovals of a previous insurer for a window of time after someone switches plans.

Oz called the practice “a pox on the system” that hikes administrative costs during his Senate confirmation hearing in March.

_____________

The Associated Press contributed to this report.